Caries Risk Assessment by CAMBRA in Children Attending a Basic Health Unit

Abstract

Objective: To determine the caries risk by Caries Management by Risk Assessment (CAMBRA) for children with mixed dentition attending a Basic Health Unit (BHU), identifying the main dental caries disease indicators, risk factors and protective factors. Material and Methods: The sample consisted of 89 children of both genders aged 8-12 years. Clinical and bitewing radiographic examinations were performed by a calibrated examiner, as well as the filling of the adapted CAMBRA form. Dental caries disease indicators, risk factors and protective factors of all subjects were determined. Chi-square test and multivariate logistic regression analysis for all CAMBRA variables were applied (p<0.05). Results: Caries risk was considered high in 38.2% of patients, moderate in 32.6% and low in 29.6%. The most frequent disease indicator was white spot lesion on smooth surfaces (73.0%), the most common risk factor was visible biofilm (78.7%) and protective factor was fluoridated water (100.0%). Children with "moderate risk" and "high risk" had risk of visible cavities or radiographic penetration of the dentin (OR=14.689; OR=574.363, respectively) compared to patients with "low risk". Conclusion: Caries risk determined as "high" and "moderate" were classifications most observed among children attending BHU. White spot lesions on smooth surfaces were the most frequent dental caries disease indicators and visible plaque on tooth surface and community water fluoridation were the most significant risk factors and protective factors, respectively.

Overweight/obese children are associated with lower caries experience than normal‐weight children/adolescents

“…Following the recommendations of Brazilian public health, the CAMBRA form was applied. Visual and radiographic examinations were performed by single examiner to detect caries disease and risk factors.…”

“…For the clinical evaluation, one examiner (ROG) participated in a previous training/calibration exercise, according to the following steps: (a) a 90‐minute ICDAS e‐learning program; (b) discussion with a reference researcher (MBD); (c) in vitro examination of 100 premolars/molars human teeth by the ICDAS visual criteria; (d) discussion of the disagreements until a consensus could be reached; and (e) in vivo examination in 10 children/adolescents. The examiner attained a kappa of 0.87 and performed all the clinical examinations with the help of a data‐recording assistant.…”

“…Visible biofilm index was classified as follows: fine (after drying the tooth surface), or thick (firmly attached to the tooth surface) . Salivary flow was evaluated during the clinical examination …”

“…The detection of visible cavities extending into the dentine (ICDAS scores 5 and 6), active white spot lesions on smooth surfaces (ICDAS scores 1 and 2), restorations in the last three years, and deep groove‐fossa system were also recorded following the CAMBRA caries risk assessment.…”

“…The balance between protective and disease factors is relevant for the dental caries equations . A practical tool to evaluate these factors is the Caries Management by Risk Assessment (CAMBRA), which is based on caries disease factors, risk factors, and protective factors …”